Vitreoretinal instruments for illumination, fluid aspiration, and photocoagulation

Abstract

The present disclosure relates generally to small-gauge instrumentation for surgical procedures, and more specifically, to vitreoretinal instruments for retinal repair and reattachment procedures, as well as associated methods of use. Certain embodiments of the present disclosure provide a curved or articulating probe configured to provide illumination, fluid aspiration, and endophotocoagulation. Accordingly, the probe enables aspiration of subretinal fluid that re-accumulates after initial drainage and during endophotocoagulation without the need to exchange surgical instruments or insert an additional instrument into the intraocular space. Furthermore, the combined functionalities of the probe enable a surgeon to simultaneously perform scleral depression with the surgeon's other hand while aspirating fluid and/or performing retinal endophotocoagulation.

What is claimed is: 
     
       1. An instrument for removing subretinal fluid from an eye, comprising:
 a handle; 
 a cannula coupled to the handle, a distal portion of the cannula having a curvature corresponding to a curvature of a retina of the eye, the cannula further comprising:
 a lumen extending through the cannula; and 
 at least one port adjacent to a distal end of the cannula for aspirating subretinal fluid from the eye into the lumen; 
 
 a first optical fiber extending through the cannula for propagating an illumination light through the distal end of the cannula; and 
 a second optical fiber extending through the cannula for propagating a laser light through the distal end of the cannula; 
 wherein the first optical fiber is joined to a third optical fiber disposed within the handle, the third optical fiber having a tapered diameter from a proximal end thereof to a distal end thereof. 
 
     
     
       2. The instrument of  claim 1 , wherein the cannula is formed from a material comprising a superelastic alloy. 
     
     
       3. The instrument of  claim 2 , wherein the superelastic alloy is nitinol. 
     
     
       4. The instrument of  claim 1 , wherein a proximal end of the handle comprises a Luer Lok-type connector for connecting the handle to an extrusion tubing for aspirating the subretinal fluid. 
     
     
       5. The instrument of  claim 4 , wherein the lumen is in fluid communication with a vacuum source via the extrusion tubing. 
     
     
       6. The instrument of  claim 1 , wherein the first optical fiber and the second optical fiber are nanofibers have a diameter of about 30 microns or less. 
     
     
       7. The instrument of  claim 1 , wherein the third optical fiber is joined to a fourth optical fiber at least partially disposed within the handle. 
     
     
       8. The instrument of  claim 6 , wherein the first optical fiber comprises a microlens at a distal end thereof to produce a divergent beam of illumination light. 
     
     
       9. The instrument of  claim 1 , wherein the first optical fiber is optically coupled to a light-emitting diode (LED) illumination source. 
     
     
       10. The instrument of  claim 1 , wherein the first optical fiber is optically coupled to a superluminescent diode (LED) illumination source. 
     
     
       11. The instrument of  claim 1 , wherein the second optical fiber is optically coupled to a narrowband or broadband laser source. 
     
     
       12. The instrument of  claim 11 , wherein the laser source is a supercontinuum laser source. 
     
     
       13. The instrument of  claim 1 , further comprising:
 an optically clear or transparent window disposed within the distal end of the cannula, the window facilitating the propagation of illumination light and laser light through the distal end of the cannula. 
 
     
     
       14. The instrument of  claim 1 , wherein the first optical fiber and the second optical fiber are coupled to an interior sidewall of the lumen opposite the at least one port.